We applaud the dedicated worker but other factors contribute to presenteeism when workers are ill. Job insecurity, fraud/corruption, wanting to stockpile leave for holidays when one is well enough to enjoy them, the desire to stay away from home if home is not where the heart is and guilt at leaving too much work to too few are other reasons staff decide to soldier on. None of these are healthy reasons to keep going when sick and can point to unhealthy culture, fearful work climate, absent or uncaring management and extreme workloads.